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General NPI Number Information
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NPI Number | 1811941321
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Entity Type | Organization
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Legal Business Name | ARIZONA PREFERRED PRIMARY CARE,PLC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 3035 S ELLSWORTH RD SUITE 103
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City | MESA
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State | AZ
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Zip | 85212
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Country | US
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Telephone | 480-736-1777
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Fax | 480-736-1144
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Provider Business Mailing Address
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Address Line | 3035 S ELLSWORTH RD SUITE 103
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City | MESA
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State | AZ
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Zip | 85212-2160
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Country | US
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Telephone | 480-736-1777
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Fax | 480-736-1144
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ABED EL NASSER S MOGHARBEL
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Credential |
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Telephone | 480-736-1184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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